African Americans and Tobacco

African Americans continue to suffer disproportionately from chronic and preventable disease compared with white Americans. Of the three leading causes of death in African Americans — heart disease, cancer, and stroke — smoking and other tobacco use are major contributors.

Health Effects

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Each year, approximately 45,000 African Americans die from a preventable smoking-related disease.

If current trends continue, an estimated 1.6 million African Americans who are now under the age of 18 years will become regular smokers. About 500,000 of those smokers will die of a smoking-related disease.

Smoking is responsible for 87% of lung cancers. African American men are at least 50% more likely to develop lung cancer than white men. African American men have a higher mortality rate of cancer of the lung and bronchus (100.8 per 100,000) than do white men (70.1 per 100,000).

Stroke is associated with cerebrovascular disease and is a major cause of death in the United States. Smoking significantly elevates the risk of stroke. Cerebrovascular disease is twice as high among African American men (53.1 per 100,000) as among white men (26.3 per 100,000) and twice as high among African American women (40.6 per 100,000) as among white women (22.6 per 100,000).

Levels of serum cotinine (metabolized nicotine) are higher among African American smokers than among white or Mexican American smokers for the same number of cigarettes.

Cigarette Smoking Prevalence

In 1997, current smoking prevalence rates were similar among African American adults (26.7%) and white adults (25.3%) in the United States.

In 1997, African American men (32.1%) smoked at a higher rate than white men (27.4%); African American women (22.4%) and white women (23.3%), however, smoked at a similar rate.

The decline of smoking among African American young people during the 1970s and 1980s was widely viewed as a great public health success. Unfortunately, recent national surveys have shown that smoking rates among African American high school students are starting to increase, although those rates are still lower than those for other students.

The 1999 National Youth Tobacco Survey (NYTS) estimates that cigarette smoking prevalence during the past month was higher among white high school students (32.8%) and lower among African American (15.8%) students. However, the rate of smoking among middle school students was similar; about 1 in 10 African American (9.0%) and white (8.8%) middle school students reported having smoked cigarettes in the past month.

The Centers for Disease Control and Prevention’s 1999 Youth Risk Behavior Surveillance System (YRBSS) report estimates that cigarette smoking prevalence during the past month was higher among white (38.6%) and Hispanic (32.7%) high school students than among African American (19.7%) students.

According to 1999 the Monitoring the Future Survey data, past month smoking prevalence was lower among African American high school seniors (14.9%) than among white (40.1%) high school seniors.

Cigarette Smoking Behavior

Approximately three of every four African American smokers prefer menthol cigarettes. Among whites, approximately a quarter of smokers prefer menthol cigarettes. Menthol may facilitate absorption of harmful cigarette smoke constituents.

Among adult African American smokers the most popular brands are Newport, Kool, and Salem. Similar brand preference was found among African American teens with 61.3 % preferred Newport, 10.9% preferred Kool, and 9.7% preferred Salem.

Prevalence of other forms of tobacco use

Aggregated National Health Interview Survey data from 1987 and 1991 show that more white men (4.8%) smoked cigars than did African American men (3.9%).

African American men (3.1%) use chewing tobacco or snuff less than white men (6.8%).

The 1999 NYTS study found that cigar use was nearly similar among white (16.0%) and African American (14.8%) high school students; African American middle school students (8.8%) were significantly more likely to smoke cigars than were white students (4.9%).

In 1999, the prevalence of smokeless tobacco use was lower among African American high school (2.4%) and middle school (1.9%) male students than among white high school (8.7%) and middle school (3.0%), and among Hispanic high school (3.6%) and middle school (2.2%) male students.

African Americans and Quitting

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Of current African American adult smokers, more than 70% indicated that they want to quit smoking completely. African American smokers are more likely than white smokers to have quit for at least one day during the previous year (29.7% compared with 26.0%).

Prevalence of cessation (the percentage of persons who have smoked at least 100 cigarettes and quit) is higher among whites (50.5%) than among African Americans (35.4%).

Tobacco Industry Economic Influence

A one-year study found that three major African American publications —Ebony, Jet, and Essence — received proportionately higher profits from cigarette advertisements than did other magazines.

The tobacco industry attempts to maintain a positive image and public support among African Americans by supporting cultural events and making contributions to minority higher education institutions, elected officials, civic and community organizations, and scholarship programs.